Positive Psychology Intervention to Treat Diabetes Distress in Teens with T1D

项目总结 患有1型糖尿病(T1D)的青少年努力达到治疗目标-只有17%的人达到了 在最近的一项全国性研究中，血糖控制--许多青少年经历了高度的糖尿病痛苦 与糖尿病护理的日常需求有关。然而，之前改善血糖控制的干预措施 患有1型糖尿病的青少年只表现出轻微到中度的影响，许多人已经- 密集且昂贵。因此，需要新的干预措施来改善青少年糖尿病患者的预后。 T1D。增加对环境的积极影响或愉悦的参与(例如，感觉快乐，快乐， (骄傲)，已被证明促进使用更适应的应对策略来管理压力。因此， 拟议的研究基于这样一个前提，即通过促进青少年糖尿病患者的积极情绪，我们将 加强适应性应对策略的使用，减少糖尿病痛苦，从而改善血糖 青少年的控制力。通过一系列迭代的试点研究，我们的研究团队适应了一种行为 使用积极心理学框架进行干预，我们证明该框架是可行和可接受的 患有T1D的青少年。这项干预旨在通过以下方式在青少年(13-17岁)中诱导积极的情绪 经过经验验证的、量身定做的感恩、自我肯定和照顾者肯定的练习。在我们的试点中 研究表明，该干预措施对青少年的生活质量、糖尿病相关压力以及 家庭冲突，所有这些都与糖尿病痛苦密切相关。我们现在计划评估这种方法的疗效 干预：多点随机对照试验。这项研究的目的是：1)评估 青少年(13-17岁)及其照顾者血糖控制的积极心理干预 评估干预对糖尿病痛苦、应对和自我照顾行为的影响；以及3)探索 干预效果在人口统计学和治疗变量上的不同影响。我们计划随机选择 200名青少年照顾者对积极情感+教育干预(n=100)或仅教育 来自两个临床站点(范德比尔特大学医学中心和国立儿童医院)的干预(n=100) 医疗中心)。通过运用积极心理学的框架，我们提出了一种创新的治疗方法 糖尿病的痛苦和改善血糖的结果。我们相信这一新的干预措施有可能 改善患有T1D的青少年的预后，并使用自动短信传递 干预为广泛传播提供了可能性。

PROJECT SUMMARY Adolescents with type 1 diabetes (T1D) struggle to meet treatment goals – only 17% met the target for glycemic control in a recent national study – and many adolescents experience high levels of diabetes distress related to the daily demands of diabetes care. Yet, previous interventions to improve glycemic control in adolescents with type 1 diabetes have only shown modest to moderate effects, and many have been time- intensive and expensive. Thus, there is a need for novel interventions to improve outcomes in adolescents with T1D. Increasing positive affect, or pleasurable engagement with the environment (e.g., feeling happy, cheerful, proud), has been shown to promote the use of more adaptive coping strategies to manage stress. Thus, the proposed study is based on the premise that, by boosting positive affect in teens with diabetes, we will enhance the use of adaptive coping strategies and reduce diabetes distress, thereby improving glycemic control in adolescents. Through an iterative series of pilot studies, our research team adapted a behavioral intervention using a positive psychology framework that we demonstrated to be feasible and acceptable for adolescents with T1D. This intervention is aimed at inducing positive affect in adolescents (age 13-17) through empirically-validated, tailored exercises in gratitude, self-affirmation, and caregiver affirmations. In our pilot studies, the intervention had promising effects on adolescents' quality of life, diabetes-related stress, and family conflict, all of which are closely linked with diabetes distress. We now plan to evaluate the efficacy of the intervention in a multisite, randomized controlled trial. The aims of this study are to 1) evaluate the effects of a positive psychology intervention for adolescents (age 13-17) and their caregivers on glycemic control; 2) evaluate the effects of the intervention on diabetes distress, coping, and self-care behavior; and 3) explore the differential impact of intervention effects across demographic and treatment variables. We plan to randomize 200 adolescent-caregiver dyads to the Positive Affect + Education intervention (n=100) or the Education only intervention (n=100) from two clinical sites (Vanderbilt University Medical Center and Children's National Medical Center). By employing a positive psychology framework, we propose an innovative approach to treat diabetes distress and improve glycemic outcomes. We believe this novel intervention has the potential to improve outcomes in adolescents with T1D, and the use of automated text messaging to deliver the intervention offers possibilities for wide dissemination.